Bronchial asthma is now quite common. When the disease affects the quality of life of the patient. The danger of such a disease also lies in the fact that the lack of adequate therapy can lead to death in children and adults.

With the current level of development of medicine, this disease is not completely curable, but it is possible to slow down and stop the disease by selecting a highly effective treatment.

Which drugs should be used in each case depends on many factors, but there are certain rules. Therapy for bronchial asthma should be:

• Complex;
• timely;
• Combine all existing methods of combating the disease.

Non-drug treatment includes the following range of activities:

• maintaining a healthy lifestyle: quitting smoking, weight loss;
• elimination of external factors provoking an exacerbation of the disease - a change of place of work, a climatic zone, air humidification in a sleeping room, elimination of allergens;
• training patients in special schools, where they are explained how to use inhalers correctly, assess their condition, and stop a mild attack;
• constant monitoring of your well-being in dynamics;
• Exercise therapy and breathing exercises.

Medical therapy is aimed at:

• reduction in the number of exacerbations of the disease;
• an obstacle to the development of complications (asthmatic status);
• achieving sustained remission.

Dynamic monitoring of the patient is carried out every 3 months. It evaluates:

• clinical picture (complaints);
• the number of hits;
• frequency of calls for emergency medical care;
• daily activity;
• the need to use short-acting drugs;
• improvement of indicators of function of external respiration;
• adverse reactions when using asthma medications.

If the treatment is ineffective, doses are adjusted, the prescribed therapy is increased.

However, the doctor must make sure that the patient follows all the instructions and the correct use of drugs. Often behind a poor response to adequate therapy lies the patient's ignorance of how to carry out inhalation aerosols.

Emergency medicines for an attack

What medications to take to treat asthma in an emergency should be known to both patients and their loved ones in order to help as quickly as possible during an attack. To stop this condition, short-acting drugs are prescribed. Their effect occurs immediately after inhalation. At the same time, they have a pronounced bronchodilatory effect, making the patient feel better.

List of essential drugs for emergency care:

• Berotek;
• Atrovent;
• Berodual.

Bronchodilator drugs for asthma are used both as a first aid agent and as part of basic therapy.

Salbutamol is available only as a finished aerosol inhaler. This medicine can be taken several times in a row with an interval of 10-15 minutes with incomplete relief of the attack.

Berotek, Atrovent, Berodual may be in the form of a solution for inhalation. In this case, nebulizers are used. The advantage of this method of treatment is the duration of inhalation. It passes for 15-20 minutes, while the patient sits and breathes through the mask, and the active substances most effectively exert their therapeutic effect.
Berodual is a combined drug, which increases the frequency of its appointment.

Long-acting powder inhalers can also be used to stop an asthma attack:

The use of certain drugs for relief should not be accidental; only the attending physician can decide on their effectiveness and safety.

With a moderate and severe asthma attack, it is necessary to call an ambulance as soon as possible, because if the inhalations are ineffective, status asthmaticus, a life-threatening condition for the patient, may develop.

Dosage, frequency of administration, features of the use of a particular drug for asthma must be agreed with your doctor! Self-medication in this case can lead to sad consequences. Bronchial asthma cannot be cured, but the prerogative of modern medicine is the appointment of adequate basic therapy to control the disease. At the same time, the patient's condition does not worsen and his quality of life is preserved.

Content

Among chronic diseases of the respiratory system, bronchial asthma is often diagnosed. It significantly impairs the quality of life of the patient, and in the absence of adequate treatment can lead to complications and even death. The peculiarity of asthma is that it cannot be cured completely. The patient throughout his life must use certain groups of drugs that are prescribed by a doctor. Medicines help to stop the disease and enable a person to lead a normal life.

Treatment of bronchial asthma

Modern drugs for the treatment of bronchial asthma have different mechanisms of action and direct indications for use. Since the disease is completely incurable, the patient has to constantly follow the correct lifestyle and doctor's recommendations. This is the only way to reduce the number of asthma attacks. The main direction of treatment of the disease is the termination of contact with the allergen. Additionally, treatment should solve the following tasks:

• reduction of asthma symptoms;
• prevention of seizures during exacerbation of the disease;
• normalization of respiratory function;
• taking the minimum amount of medication without compromising the health of the patient.

A healthy lifestyle involves quitting smoking and weight loss. To eliminate the allergic factor, the patient may be advised to change the place of work or climatic zone, humidify the air in the sleeping room, etc. The patient must constantly monitor his well-being, do breathing exercises. The attending physician explains to the patient the rules for using the inhaler.

You can not do without medication in the treatment of bronchial asthma. The doctor chooses drugs depending on the severity of the disease. All drugs used are divided into 2 main groups:

• Basic. These include antihistamines, inhalers, bronchodilators, corticosteroids, antileukotrienes. In rare cases, cromones and theophyllines are used.
• Funds for emergency assistance. These medicines are needed to stop asthma attacks. Their effect appears immediately after use. Due to the bronchodilator action, such drugs facilitate the patient's well-being. For this purpose, Salbutamol, Atrovent, Berodual, Berotek are used. Bronchodilators are part of not only basic, but also emergency therapy.

The basic therapy scheme and certain medications are prescribed taking into account the severity of the course of bronchial asthma. There are four levels in total:

• First. Does not require basic therapy. Episodic seizures are stopped with the help of bronchodilators - Salbutamol, Fenoterol. Additionally, membrane cell stabilizers are used.
• Second. This severity of bronchial asthma is treated with inhaled hormones. If they do not bring results, then theophyllines and cromones are prescribed. Treatment necessarily includes one basic drug, which is taken constantly. They can be an antileukotriene or an inhaled glucocorticosteroid.
• Third. At this stage of the disease, a combination of hormonal and bronchodilator drugs is used. They already use 2 basic medications and Β-adrenergic agonists for the relief of seizures.
• Fourth. This is the most severe stage of asthma, in which theophylline is prescribed in combination with glucocorticosteroids and bronchodilators. The drugs are used in tablet and inhalation forms. The first aid kit for an asthmatic already consists of 3 basic drugs, for example, antileukotriene, inhaled glucocorticosteroid and long-acting beta-agonists.

Overview of the main groups of drugs for bronchial asthma

In general, all asthma medications are divided into those that are used regularly and those used to relieve acute attacks of the disease. The latter include:

• Sympathomimetics. These include Salbutamol, Terbutaline, Levalbuterol, Pirbuterol. These medicines are indicated for emergency treatment of choking.
• Blockers of M-cholinergic receptors (anticholinergics). They block the production of special enzymes, contribute to the relaxation of bronchial muscles. Theophylline, Atrovent, Aminophylline have this property.

Inhalers are the most effective treatment for asthma. They relieve acute attacks due to the fact that the medicinal substance instantly enters the respiratory system. Examples of inhalers:

• Becotid;
• Budesonide;
• Flixotide;
• Flukatisone;
• Benacort;
• Ingacourt;
• Flunisolide.

Basic drugs for bronchial asthma are represented by a wider range of drug groups. All of them are necessary to alleviate the symptoms of the disease. For this purpose, apply:

• bronchodilators;
• hormonal and non-hormonal agents;
• cromones;
• antileukotrienes;
• anticholinergics;
• beta-agonists;
• expectorants (mucolytics);
• mast cell membrane stabilizers;
• antiallergic drugs;
• antibacterial drugs.

Bronchodilators for bronchial asthma

This group of drugs for their main action is also called bronchodilators. They are used both in inhalation and in tablet form. The main effect of all bronchodilators is the expansion of the lumen of the bronchi, due to which an asthma attack is removed. Bronchodilators are divided into 3 main groups:

• beta-agonists (Salbutamol, Fenoterol) - stimulate the receptors of mediators of adrenaline and noradrenaline, are administered by inhalation;
• anticholinergics (blockers of M-cholinergic receptors) - do not allow the acetylcholine mediator to interact with its receptors;
• xanthines (theophylline preparations) - inhibit phosphodiesterase, reducing the contractility of smooth muscles.

Bronchodilator drugs for asthma should not be used too often, as the sensitivity of the respiratory system to them decreases. As a result, the drug may not work, increasing the risk of death from suffocation. Examples of bronchodilator drugs:

• Salbutamol. The daily dose of tablets is 0.3-0.6 mg, divided into 3-4 doses. This drug for bronchial asthma is used in the form of a spray: 0.1–0.2 mg is administered to adults and 0.1 mg to children. Contraindications: ischemic heart disease, tachycardia, myocarditis, thyrotoxicosis, glaucoma, epileptic seizures, pregnancy, diabetes mellitus. If the dosage is observed, side effects do not develop. Price: aerosol - 100 rubles, tablets - 120 rubles.
• Spiriva (ipratropium bromide). The daily dose is 5 mcg (2 inhalations). The medicine is contraindicated under the age of 18, during the first trimester of pregnancy. Side effects may include urticaria, rash, dry mouth, dysphagia, dysphonia, itching, coughing, coughing, dizziness, bronchospasm, and throat irritation. The price of 30 capsules 18 mcg is 2500 rubles.
• Theophylline. The initial daily dosage is 400 mg. With good tolerance, it is increased by 25%. Contraindications of the drug include epilepsy, severe tachyarrhythmias, hemorrhagic stroke, gastrointestinal bleeding, gastritis, retinal hemorrhage, age less than 12 years. Side effects are numerous, so they should be clarified in the detailed instructions for Theophylline. The price of 50 tablets of 100 mg is 70 rubles.

Mast cell membrane stabilizers

These are anti-inflammatory drugs for the treatment of asthma. Their action is the effect on mast cells, specialized cells of the human immune system. They take part in the development of an allergic reaction, which underlies bronchial asthma. Mast cell membrane stabilizers prevent the entry of calcium into them. It does this by blocking the opening of calcium channels. The following drugs produce such an effect on the body:

• Nedocromil. Used from 2 years of age. The initial dosage is 2 inhalations 2-4 times a day. For prevention - the same dose, but twice a day. Additionally, it is allowed to carry out 2 inhalations before contact with the allergen. The maximum dose is 16 mg (8 inhalations). Contraindications: first trimester of pregnancy, age less than 2 years. Of the adverse reactions, cough, nausea, vomiting, dyspepsia, abdominal pain, bronchospasm, and unpleasant taste are possible. Price - 1300 rubles.
• Cromoglycic acid. Inhalation of the contents of the capsule (powder for inhalation) using a spinhaler - 1 capsule (20 mg) 4 times a day: in the morning, at night, 2 times in the afternoon after 3-6 hours. Solution for inhalation - 20 mg 4 times a day. Possible side effects: dizziness, headache, dry mouth, cough, hoarseness. Contraindications: lactation, pregnancy, age up to 2 years. The cost of 20 mg is 398 rubles.

Glucocorticosteroids

This group of drugs for bronchial asthma is based on hormonal substances. They have a strong anti-inflammatory effect, removing the allergic swelling of the bronchial mucosa. Glucocorticosteroids are represented by inhaled drugs (Budesonide, Beclomethasone, Fluticasone) and tablets (Dexamethasone, Prednisolone). Good reviews are used by such tools:

• Beclomethasone. Dosage for adults - 100 micrograms 3-4 times a day, for children - 50-100 micrograms twice a day (for the release form, where 1 dose contains 50-100 micrograms of beclomethasone). With intranasal use - in each nasal passage, 50 mcg 2-4 times daily. Beclomethasone is contraindicated under the age of 6 years, with acute bronchospasm, non-asthmatic bronchitis. Among the negative reactions may be coughing, sneezing, sore throat, hoarseness, allergies. The cost of a bottle of 200 mcg is 300–400 rubles.
• Prednisolone. Since this drug is hormonal, it has many contraindications and side effects. They should be clarified in the detailed instructions for Prednisolone before starting treatment.

Antileukotriene

These new generation anti-asthma drugs have anti-inflammatory and antihistamine effects. In medicine, leukotrienes are biologically active substances that are mediators of allergic inflammation. They cause a sharp spasm of the bronchi, resulting in coughing and asthma attacks. For this reason, antileukotriene drugs for asthma are the first-line drugs of choice. The patient may be given:

• Zafirlukast. The initial dose for the age of 12 years is 40 mg, divided into 2 doses. Maximum per day can be taken 2 times 40 mg. The medicine can cause an increase in the activity of liver transaminases, urticaria, rash, headache. Zafirlukast is contraindicated in pregnancy, lactation and hypersensitivity to the composition of the drug. The cost of the medicine is from 800 r.
• Montelukast (Singular). As a standard, you need to take 4-10 mg per day. Adults are prescribed 10 mg before going to bed, children - 5 mg. The most common negative reactions: dizziness, headaches, indigestion, swelling of the nasal mucosa. Montelukast is absolutely contraindicated in case of allergy to its composition and under the age of 2 years. A pack of 14 tablets costs 800–900 rubles.

Mucolytics

Bronchial asthma causes the accumulation of viscous thick mucus in the bronchi, which interferes with the normal breathing of a person. To remove sputum, you need to make it more liquid. For this purpose, mucolytics are used, i. expectorants. They dilute sputum and forcibly remove it by stimulating coughing. Popular expectorants:

• Acetylcysteine. It is taken 2-3 times a day for 200 mg. For aerosol application, 20 ml of a 10% solution is sprayed using ultrasonic devices. Inhalations are done daily 2-4 times for 15-20 minutes. Acetylcysteine ​​is prohibited for use in gastric and duodenal ulcers, hemoptysis, pulmonary hemorrhage, pregnancy. The cost of 20 sachets of medicine is 170–200 rubles.
• Ambroxol. Recommended to be taken at a dosage of 30 mg (1 tablet) twice a day. Children 6–12 years old are given 1.2–1.6 mg / kg / day, divided into 3 doses. If syrup is used, then the dose at the age of 5-12 years is 5 ml twice a day, 2-5 years - 2.5 ml 3 times every day, up to 2 years - 2.5 ml 2 times / day.

Antihistamines

Bronchial asthma provokes the decomposition of mast cells - mastocytes. They release a huge amount of histamine, which causes the symptoms of this disease. Antihistamines in bronchial asthma block this process. Examples of such medications:

• Claritin. The active ingredient is loratadine. Daily you need to take 10 mg of Claritin. It is forbidden to take this drug for bronchial asthma in lactating women and children under 2 years of age. Negative reactions may include headaches, dry mouth, gastrointestinal disorders, drowsiness, skin allergies, and fatigue. A package of 10 tablets of 10 mg costs 200–250 rubles. Semprex and Ketotifen can be cited as analogues of Claritin.
• Telfast. Every day you need to take 1 time for 120 mg of this medicine. Telfast is contraindicated in case of allergy to its composition, pregnancy, breastfeeding, children under 12 years of age. Often after taking the pill there are headaches, diarrhea, nervousness, drowsiness, insomnia, nausea. The price of 10 Telfast tablets is 500 rubles. The analogue of this drug is Seprakor.

Antibiotics

Medicines from the group of antibiotics are prescribed only when a bacterial infection is attached. In most patients it is caused by pneumococcal bacteria. Not all antibiotics can be used: for example, penicillins, tetracyclines and sulfonamides can cause allergies and not give the desired effect. For this reason, more often the doctor prescribes macrolides, cephalosporins and fluoroquinolones. The list of adverse reactions is best specified in the detailed instructions for these drugs, since they are numerous. Examples of antibiotics used for asthma:

• Sumamed. Medicine from the group of macrolides. It is prescribed for use 1 time per day, 500 mg. Treatment lasts 3 days. The dose of Sumamed for children is calculated from the condition of 10 mg / kg. At the age of six months to 3 years, the drug is used in the form of a syrup in the same dosage. Sumamed is prohibited for violations of kidney and liver function, while taking with ergotamine or dihydroergotamine. The price of 3 tablets of 500 mg is 480-550 rubles.
• Abaktal. An antibiotic from the group of fluoroquinolones. It is taken twice a day at 400 mg, observing a break between doses of 12 hours. You can not use Abaktal for hemolytic anemia, pregnancy, lactation, under the age of 18 years. The cost of 10 tablets of this antibiotic is 250 rubles.
• Cefaclor. Representative of cephalosporin antibiotics. The average dose of the drug is 750 mg. It is divided into 3 doses per day. The only limitation to treatment with Cefaclor is an allergy to its composition. A package of 10 tablets of 125 mg costs about 200-300 rubles.

Video

The quality of life of people suffering from bronchial asthma - wishes for the best! But properly selected therapy will help to significantly alleviate the patient's condition, reduce the frequency and intensity of exacerbations. An integral part of the treatment are drugs for bronchial asthma, the mechanism of action of which will help not only stop an asthmatic attack, but also reduce the risk of its development. To date, great progress has been made in the treatment of this disease. A few years ago, bronchial asthma therapy consisted only of stopping attacks, but now, thanks to basic treatment, it is possible to keep the disease under control.

The pharmaceutical industry offers a fairly large range of drugs for the treatment of bronchial asthma, but the choice of any drug is always up to the attending physician. In the past few years, doctors have increasingly used a stepwise approach to the treatment of bronchial asthma, which consists of individual prescribing of drugs depending on the stage of the disease, the intensity of attacks. The main goal of such treatment is considered to be the control of the disease with the help of a certain medicine. The dose of drugs can increase (step up) or decrease (step down). Drug treatment of bronchial asthma is determined by the attending physician individually for each patient, based on clinical signs, frequency and severity of attacks.

All drugs for bronchial asthma are divided into two main types: emergency drugs (bronchodilators) for an attack (symptomatic) or drugs to control the disease (planned basic therapy).

Symptomatic therapy includes the use of drugs that can stop asthma attacks: choking, shortness of breath, dry cough, wheezing. In the acute period, drugs from the group of fast-acting beta-2-agonists (bronchodilators) are used, which have the ability to alleviate the patient's condition during an attack. Such drugs act almost immediately, are available in the form of a pocket metered dose inhaler, which should always be present with a person: Salbutamol, Ventolin and others. With intolerance to drugs beta-2-agonists, the patient may be prescribed anticholinergics (Atrovent), which act more slowly, but also give good results in stopping an asthmatic attack.

Basic therapy consists of taking medications, the mechanism of action of which is aimed at treating bronchial asthma, preventing the development of acute periods, and improving the quality of human life. Basic preparations are intended for daily use. Their use allows you to reduce swelling of the bronchi, relieve the inflammatory process in the respiratory tract, reduce sensitivity to certain allergens. These drugs include corticosteroids, antihistamines, mucolytics, antileukotriene drugs. In severe forms of the disease, the doctor may prescribe drugs from the group of theophyllines or cromones (non-hormonal), but such drugs are not prescribed for children, because they have many contraindications.

First aid preparations

First aid medicines for asthma are bronchodilators, which have the ability to relieve bronchospasm, shortness of breath, asthma attacks and other symptoms.

Bronchodilators are often called bronchodilators, which come in 3 types:

1. β2-agonists.
2. Xanthines.
3. Anticholinergics.

Drugs from the group of β2-agonists are divided into short-acting and long-acting drugs. The first type includes drugs such as Salbutamol, Berotek, Fenoterol, Ventolin. For long-acting drugs - Salmeterol, Formoterol.
In asthma attacks, preference is given to drugs for inhalation administration, since they allow you to quickly alleviate the patient's condition, stop an acute attack.

Cholinolytics - drugs for the relief of asthmatic attacks. They are used in cases where the patient does not tolerate beta-2-agonists - Troventol, Atrovent, Atropine, Platifillin, Belloid, which are also available in the form of a local metered aerosol or injection ampoules.

In severe forms, first aid drugs are prescribed, which include taking systemic hormones that are administered intravenously, intramuscularly or orally: Prednisolone, Dexamethasone and others.

It is important to understand that all drugs used to relieve an asthmatic attack do not cure the disease, but only relieve its acute symptoms for a while.

Basic drugs in the treatment of bronchial asthma

The principle of action of basic therapy is to take medications that allow you to neutralize inflammatory processes in the respiratory tract, reduce swelling in the bronchial mucosa, and suppress allergic reactions.

Antihistamines

It is known that bronchial asthma most often has an allergic origin, so taking antiallergic drugs is an integral part of medical therapy. Basically, the doctor prescribes new generation drugs that act within 24 hours. Such drugs have the ability to suppress the release of histamine, block hypersensitivity to allergens: Erius, Citrine, Claritin, Eden and others, which are available in the form of tablets for adults or in the form of drops, syrup for children. The duration of taking antihistamines can take from several days to several weeks. The dose of any agent is set individually for each patient, in accordance with age, stage of the disease and other characteristics of the body.

Corticosteroids

Preparations from the group of corticosteroids are used in the treatment of moderate and severe stages of bronchial asthma. Such drugs reduce bronchial obstruction, shortness of breath, and can be used to relieve an attack. Corticosteroids are hormones, they have a lot of contraindications, so they can only be prescribed by a doctor. Corticosteroid drugs include Prednisolone, Hydrocortisone, Dexamethasone, and others. Available in several forms: ampoules for injection, tablets, solution for inhalation.

Antileukotriene drugs

This group of drugs is designed to eliminate bronchospasm, which is caused by inflammatory processes in the mucous membrane of the respiratory tract. Basically, such funds are intended for bronchial asthma, which manifested itself against the background of a viral or infectious disease. Antileukotriene drugs are intended for long-term use, complement the main treatment: Zileuton, Zafirlukast, Montelukast.

Cromons

A group of drugs that contain cromonic acid, which has an anti-asthma effect. Medicines based on this substance reduce the production of mast cells, thereby eliminating bronchospasm. During the period of exacerbation, such drugs are not used, only as part of basic therapy: Ketoprofen, Ketotifen, Intal and others.

Glucocortisteroids

Drugs with a powerful anti-inflammatory effect that reduce swelling of the bronchial mucosa, stimulate sputum discharge, relieve inflammation. Such drugs are produced in various pharmacological forms - aerosols, nebulas for a nebulizer, tablets. Any remedy from this group of drugs has many contraindications and side effects, therefore, it can only be used as directed by a doctor: Ingacort, Becloment, Bekotid, Pulmicort. Anti-inflammatory drugs are taken as a prevention of asthmatic attacks and exacerbations for a long time.

Andrenomimetics

The action of drugs from this group is aimed at expanding the bronchi. The effect of use lasts for 12 hours. Such medicines are intended for long-term use, since the result from their use will not be noticeable immediately, but after a while: Saltos, Spiropent, Foradil.

Basic therapy is designed for a long time. Some medicines the patient is forced to take throughout his life. In the process of taking any remedy, it is very important to follow the recommended doses, do not cancel the drug on your own or prescribe a new one without consulting a doctor. With the right therapy, asthma can be kept under control.

Symptomatic therapy

During the period of exacerbation of bronchial asthma, doctors often prescribe drugs to relieve individual symptoms. The basis of symptomatic treatment is expectorant drugs, the use of which will clear the airways of accumulated mucus, normalize breathing, and reduce shortness of breath. Most often, in the treatment of bronchial asthma, ambroxol preparations are used - Lazolvan, Ambrobene, Ambroxol, Mukolvan and others. Such funds are produced in various forms, including a solution for inhalation.

Exacerbation of bronchial asthma often occurs against the background of viral or bacterial infections, so it is possible that during such a period the doctor will prescribe antiviral or antimicrobial drugs. Taking antibiotics in some way will help speed up the recovery period, suppress the vital activity of pathogenic microbes. Asthmatics are not recommended to use penicillins or sulfonamides, as they can exacerbate the symptoms of the disease, aggravate the patient's condition. Preference is given to drugs from the group of cephalosporins, macrolides, fluoroquinolones. Taking any antibiotic or antiviral medication must be agreed with the doctor.

With frequent exacerbations of bronchial asthma, doctors recommend monitoring the state of the immune system, eating right, leading a healthy lifestyle, as well as periodically undergoing examinations and monitoring the disease. In addition to asthma medications, it is very important to determine the cause, to exclude any etiological factor that can cause an exacerbation of the disease.

What medicines are used in the treatment of asthma?

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Drugs in the treatment of bronchial asthma
Therapy bronchial asthma with the use of medicines today is one of the main methods of treating this disease in different age categories. Over the past decade, a lot of drugs have been synthesized that significantly alleviate the condition of patients and prevent the occurrence of complications. At the same time, new drugs are becoming more and more harmless to the patient's body. Thus, therapy must meet two criteria: harmlessness and effectiveness. Methods of therapy in patients of different groups are different at different stages of the disease. In addition, the treatment regimen also depends on the individual reaction of the body. Next, the main types of drugs used to treat this disease and the multi-stage therapy regimen used today will be outlined.

What drugs are used in the treatment of bronchial asthma?

Modern principles of bronchial asthma therapy outlined in the program GINA aimed at controlling the course of the disease. Quality control over the course of the disease implies the following concepts:

• Reducing disease symptoms as much as possible
• Prevention of exacerbations of the disease or reduction of the possibility of exacerbations,
• Reducing the number of drugs used or treatment with little to no side effects,
• Normalization of respiratory function.

So, this method of asthma therapy is aimed at regulating the principle of harmlessness-effectiveness in the treatment of bronchial asthma. Drug therapy involves the use of drugs from a large number of pharmacological groups, as well as with a variety of principles of action. The most commonly used groups of medications used in the treatment of asthma in patients of different age categories will be listed below.

Medicines from the cromon group
Medicines from this group, created on the basis of cromonic acid (nedocromil, sodium cromoglycate ) effectively reduce inflammation and also have an anti-asthma effect. Medicines from this group slow down the synthesis of certain components of mast cells, which provoke inflammatory processes, as well as a decrease in the inner diameter of the bronchi. Cromones are used in the main therapy of the disease, but their use is not allowed in therapy during an exacerbation. The use of drugs in this group is not welcome in children under the age of six.

Glucocorticoid drugs in the form of inhalations
Drugs in this group significantly reduce inflammation and also suppress local immune responses. Preparations in the form of inhalations from the group of glucocorticoids ( IGK), such as the fluticasone, budesonide or beclomethasone used to treat asthma. Such a dosage form makes it possible to reduce the amount of the drug taken, and also activates the action. Today, the drugs in this group are the only ones approved for use in the treatment of asthma in children under the age of three. If you carefully follow the instructions received at the consultation of the allergist, the strength and number of side effects from treatment with such drugs are minimal.

Systemic glucocorticoids in the treatment of bronchial asthma
The use of systemic glucocorticoids ( dexamethasone, prednisolone ) in the treatment of this disease is allowed only in the most extreme cases. Long-term use of these drugs is not recommended as they cause severe side effects ( obesity, adrenal atrophy, cataracts, hypertension, diabetes).

Medications from the group of beta-2-agonists
Medicines from this group formoterol, salmeterol ) have the property of expanding the lumen of the bronchi. These funds do not cause severe adverse reactions in the baby's body and they are often used as one of the medicines in the treatment of bronchial asthma. Short-acting beta-2 agonists such as salbutamol are used to treat asthma attacks.

Combined funds: beta-2-agonists + IGK in the treatment of bronchial asthma
combination medicines ( seretide, symbicort ) include in their composition and beta-2-agonists of prolonged action and IGK. So, these drugs relieve bronchospasm, and also significantly reduce inflammation. Modern principles of asthma therapy involve the use of combined agents both as the main treatment and for the relief of exacerbations.

Leukotriene receptor antagonists in the treatment of bronchial asthma
Leukotrienes- These are substances that are produced during the inflammatory process in the body and which provoke intense bronchospasm. Medicines from this group, such as montelukast or zafirlukast are used as a fallback treatment for asthma. These drugs are prescribed for the treatment of the disease in babies.

Drugs from the methylxanthines group in the treatment of bronchial asthma
Today, the use of drugs from this group ( theophylline) in the treatment of this disease is significantly limited. The use of these funds can cause very serious consequences in young patients. (violation of the rhythm of the heartbeat, as well as the possibility of a sudden death).

Anticholinergic drugs in the treatment of bronchial asthma
Medicines from this group are used in the treatment of bronchospasm in bronchial asthma. Since drugs cause a fairly large number of side effects, drugs are used in the treatment of children very rarely.

Multistage asthma therapy regimen

The scheme outlined below assumes the distribution of patients into groups, including patients with a similar course and severity of the disease, as well as the level of asthma control. Therapy of patients of one group is one step. When the treatment rises to the next level, this indicates a deterioration in the patient's condition and the need to use more drugs. A decrease by one step indicates the need to reduce the number of drugs.

There are 4 stages of asthma therapy:

1st step- mild intermittent degree of the disease
2nd stage- mild persistent disease
3rd step- moderate persistent disease
4th step- severe persistent disease

The type of medications used, as well as the treatment regimen, is prescribed only at the consultation of an allergist individually. If the therapy does not bring the expected relief at one stage, one should go up one stage. If the disease is sufficiently effectively controlled, it is allowed to go down one step under the guidance of the attending physician.

Ambroxol - full description

Ambroxol- This is a drug of the latest generations, used for inflammation of the respiratory system to change the rheological properties of bronchial mucus and accelerate its evacuation from the respiratory system. In addition, ambroxol is used to accelerate the maturation of lung tissue in babies born prematurely.

What is the function of ambroxol?
bronchial mucus is a substance produced in the respiratory organs during inflammation ( allergic or infectious nature). Bronchial mucus includes two components: mucus and serous part. Mucus is a thick part that consists of glycoproteins and proteins. There are ailments in which, due to an increase in the work of the glands of the respiratory mucosa, sputum is produced with a predominance of the mucous component. Such sputum is very viscous and difficult to remove from the respiratory system, and the cough is painful and unproductive. Ambroxol affects the protein part of sputum, making it less thick. In addition, the drug activates the work of the serous glands of the respiratory organs, which produce the liquid component of sputum, reducing its density. Also, the drug enhances the action of the cilia that make up the bronchial mucosa. Their movement ensures the withdrawal of sputum, and with it microbes, and dust from the bronchi to the nasopharynx. Numerous experiments have proven the ability of the drug to enhance the production surfactant- a special substance that lines the inner surface of the alveoli of the lungs, as well as inhibiting their shrinkage. This quality of ambroxol is used in the treatment of pulmonary insufficiency, called distress syndrome, in babies who were born prematurely.

What processes does the drug cause?
Ambroxol is produced in the form of syrup and pills. When the drug enters the digestive organs, the active ingredient enters the blood in a short time. The effect of the drug comes within half an hour after use, and lasts six to twelve hours. The evacuation of the drug occurs through the kidneys, in connection with this, in patients suffering from chronic renal failure, the period of evacuation of the drug is lengthened. Some traces of the drug are present in breast milk, but the amount is so scanty that it does not harm the health of the baby who consumes breast milk.

When is Ambroxol prescribed?
Ambroxol can be purchased without a prescription. The purpose for the use of the drug is inflammation of the respiratory system, passing with the production of thick mucus: chronic bronchitis, tracheobronchitis, COPD (chronic obstructive pulmonary disease), bronchiectasis, bronchial asthma, cystic fibrosis, pneumonia.

Method of use and dosage
The drug is produced in the form of tablets of thirty milligrams and in the form of syrup in bottles of one hundred and one hundred and fifty milliliters. Tablets are taken orally with food, after which some water is drunk. Adolescents from twelve years old, as well as patients of mature age, should take one tablet ( thirty milligrams) three times a day for the first two to three days, then half a tablet ( fifteen milligrams) three times a day or a whole tablet twice a day. Children up to the age of twelve take half a tablet twice or thrice a day. The drug in the form of a syrup is produced in a concentration of fifteen milligrams in five milliliters and thirty milligrams in five milliliters. So, the amount of syrup per dose varies depending on the content of the active ingredient. Patients over the age of twelve should receive thirty milligrams three times a day. Babies up to the age of twelve receive fifteen milligrams three times a day. Do not use the medicine for more than five days without consultation

What drugs are usually prescribed for bronchial asthma. What is the main algorithm now used for this: asthma treatment in accordance with the stage of the disease.
Nowadays, more and more people suffer from bronchial asthma. In this regard, the methods of treatment and drugs that are used for this are undergoing changes. Some drugs completely disappear from the standard list of prescriptions, while others, on the contrary, proving their effectiveness, firmly occupy a place in modern treatment regimens.

Each of the adult patients needs to know which groups of asthma drugs are now most in demand in order to correctly adjust the composition of their home first aid kit.

Almost all groups of drugs used in bronchial asthma have an inhibitory effect on one or another link in the holistic mechanism of the development of the disease. Let's dwell on the latter in more detail.

The diagram shows the main participants in the reaction of the bronchi in bronchial asthma

At the heart of the onset of the symptoms of the disease is a transient different-sized bronchial obstruction, that is, a temporary narrowing of different parts of the bronchial tree, which manifests itself to an unequal degree.

It all starts with the fact that the bronchial mucosa is affected by an agent to which the latter has an increased sensitivity. This agent causes and maintains chronic inflammation in it. The microvessels of the mucous membrane overflow with blood, inflammatory cells migrate into the inflammatory focus, which include the following:

Inflammatory cells secrete specific substances, which are called inflammatory mediators, for example, histamine, leukotrienes. These substances lead to the fact that there is a spasm of smooth muscle cells in the walls of the bronchi, which is accompanied by a narrowing of the lumen of the latter. Drugs that are usually used for bronchial asthma interfere with this process.

Disease control system

Now the medical world has adopted a recently developed concept of asthma control. It suggests that drugs should be prescribed according to the stage of the disease. In total, there are five stages of bronchial asthma. With each new step, the patient's first-aid kit is filled with more than one drug. If the disease is not too severe, it is enough for the patient to use drugs on demand, that is, only during an attack.

The decisive link in determining the stage of the disease in adult patients is the frequency and severity of asthma attacks.

• Stage I involves the so-called intermittent course of the disease, in other words, asthma in this case is called episodic. This means that the symptoms of the disease, such as shortness of breath, coughing and wheezing, resembling a whistle, appear in the patient no more than 1 time per week. At the same time, attacks at night occur no more than 2 times a month. Between attacks, the symptoms of the disease do not bother the patient at all. The lungs, according to spirometry and peak flow, are functioning normally.
• Stage II corresponds to mild persistent asthma. This means that the symptoms of the disease overtake the patient once a week or even more often, but not every day. Attacks at night occur more often than 2 times a month. During an exacerbation, the patient's usual activity may be disturbed. Peakfluometry data are such that they indicate some increase in the sensitivity of the patient's bronchi.
• Stage III corresponds to persistent asthma of moderate severity. This means that the patient notes the symptoms of the disease every day, exacerbations significantly disrupt his usual activity and rest. Attacks at night occur more than once a week. Usually the patient can no longer do a day without at least short-acting drugs.
• Stage IV corresponds to severe persistent asthma. This means that the symptoms accompany the patient every day throughout the day. The disease imposes serious restrictions on the habitual activity of the patient. According to spirometry data, usually all indicators are significantly reduced and are less than 60% of what should be, that is, normal for a person with the same parameters as in a particular patient.
• V step. It is characterized by extremely frequent exacerbations and serious deviations. Often attacks occur, as if, for no apparent reason, more than once a day. The patient needs active maintenance therapy.

Overview of the main groups of drugs

Drugs that are commonly used in bronchial asthma have different mechanisms of action, degrees of effectiveness and direct indications for prescription. Consider the main means by which an asthmatic first-aid kit should be presented.

• Bronchodilators.

Bronchodilators combine under their name all those drugs that expand the lumen of the bronchi, relieving bronchospasm. These include the following drugs:

However, usually in severe cases of the disease, corticosteroids are introduced into the patient's body systemically. Systemic corticosteroids include prednisolone, dexamethasone.

• Mast cell membrane stabilizers.

Cromoglycic acid drug

The drugs in this group are also anti-inflammatory. They affect mast cells, which are actively involved in inflammatory reactions. Mast cell membrane stabilizers are drugs such as cromoglycic acid, nedocromil.

• Leukotriene receptor antagonists.

Leukotrienes are inflammatory mediators, and anti-leukotriene agents have an anti-inflammatory effect. The drugs in this group include zafirlukast and montelukast (Singulair).

• Monoclonal antibodies to immunoglobulin E.

Monoclonal antibody preparations are relatively new. Specific antibodies that bind to immunoglobulin E and remove it from an allergic reaction if bronchial asthma is allergic. To use such drugs, the fact of the allergic nature of asthma must be proven, that is, confirmed by an additional study of the level of immunoglobulin E in the patient's blood.

Produced overseas. In vitro, usually in mice.

• Mucolytics.

Mucolytics, that is, expectorants, are rather used not for the treatment of the disease itself, but for some relief of the patient's condition as a whole. The bronchi of an asthmatic produce a lot of thick vitreous mucus, facilitating its separation, of course, will contribute to good health and freer breathing of the patient. Mucolytics are illustrated by drugs such as acetylcysteine, ambroxol.

Treatment of asthma at every stage of the disease

At the first stage of the disease, the patient needs drugs only occasionally, to stop the attack, which from time to time can end on their own. In order to stop an attack of the disease, short-acting β-adrenergic agonists, salbutamol or fenoterol are used by inhalation.

At the II stage of the disease, the patient's first-aid kit should already contain one basic drug. Basic preparations are taken constantly. They serve as the basis of treatment. Usually these are anti-inflammatory drugs that have a beneficial effect on the bronchial mucosa, reducing chronic inflammation in it. Stage II basic drugs are usually inhaled corticosteroids or antileukotriene agents. Also, the patient continues to use short-acting bronchodilators on demand to stop attacks of the disease.

At stage III of the disease, along with a short-acting β-blocker, 2 basic drugs are usually used to relieve an attack. Various combinations can be tried to achieve the best effect for the patient. One of the best is the combination of low doses of inhaled corticosteroids with long-acting β-blockers. Inhaled corticosteroids and antileukotriene drugs are also well combined, as in stage II. In addition, prolonged theophyllines in low doses, that is, long-acting theophyllines, can be prescribed. Drugs such as teopec or teotard.

However, these preparations must be carefully titrated. This means that they are used starting with minimal doses, eventually bringing the dose to an adequate dose for a particular patient. Usually theophyllines are prescribed at night.

It is important to remember that the strictest contraindication to the use of theophylline preparations is the presence of atrial tachyarrhythmia in a patient.

Complications in this case can be very deplorable. To the point of cardiac arrest.

At the IV stage of the disease, the patient's first-aid kit should already contain at least 3 basic drugs. For example, these may be representatives of the group of inhaled corticosteroids, the group of long-acting β-blockers, as well as antileukotriene drugs. Some patients also take long-acting theophyllines at night. Short-acting beta-blockers or anticholinergics can still be used to control an attack. However, the latter are less effective.

At the fifth stage of the disease, the composition of the first-aid kit of an asthmatic is the most numerous and diverse. Various base preparations are used. In addition to inhaled corticosteroids, systemic or oral corticosteroids are also beginning to be used, which can have a lot of side effects. Monoclonal antibodies to immunoglobulin E can also be used if its elevated blood levels and the association of the latter with asthma are proven.

What you should also know

Every asthmatic needs to know what benefits, including free medicines, they can get due to their illness.

Of course, benefits for bronchial asthma are not only related to the issuance of medicines. There are also benefits that allow you to get free travel and partial accommodation. The list that makes up the benefits of asthma is quite diverse.

Benefits relating to treatment also include benefits for obtaining spa vouchers. The patient gets the opportunity to undergo a number of strengthening procedures free of charge, which also contributes to a more favorable course of his illness.

Conclusion

Nowadays, drug treatment of bronchial asthma has acquired a certain structure. Rational pharmacotherapy of bronchial asthma consists in treating the disease depending on the stage of the disease, which is determined during the examination of the patient. The new standards of such treatment suggest fairly clear algorithms for prescribing asthmatics of various groups of drugs. Despite the fact that stage IV or even V asthma is often found among adult patients, it is usually possible to alleviate the patient's condition.

Almost all of the adult patients are eligible for sickness benefits. The composition of these benefits is determined by the relevant laws. It is important that patients can receive free medicines. What drugs can be obtained, you need to find out from your doctor, because usually medicines are issued on the basis of a medical institution.

Video: Bronchial asthma and treatment